高龄骨质疏松症病人骨折术后的治疗  

The postoperative therapy for bone fracture in elderly patients with osteoporosis

作　　者：陈富强[1] 沈珊安[1] 赵帅[1] 马一翔[1] 葛旻[1] 王安硈[1] 

机构地区：[1]上海市第二人民医院,上海200011

出　　处：《上海医药》2010年第6期266-267,共2页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:探讨高龄骨质疏松致粗隆骨折术后的继续治疗,以提高对内固定的疗效。方法:20例高龄粗隆骨折术后的病人,年龄78～96岁,平均84岁,随机分为A、B两组。A组使用密盖息、骨化三醇、活力钙治疗;B组使用骨化三醇、活力钙治疗。观察两组症状及血钙、血磷、碱性磷酸酶、尿羟脯氨酸/肌酐的变化。结果:A组治疗8wk后疼痛缓解,B组无明显改变。碱性磷酸酶在8wk后差别不明显;尿羟脯氨酸/肌酐比值,A组有所降低,B组下降不明显。结论:密盖息能提高中枢痛阈与β-内啡肽水平,起到快速缓解骨痛的作用,并有抑制骨吸收的作用。对高龄粗隆骨折术后病人利用密盖息进行综合治疗是提高手术疗效的重要方法之一。Objective： To investigate the continuous postoperative treatment of femoral intertrochanteric fracture induced by osteoporosis in elderly patients in order to strengthen the therapeutic efficacy of inter fixation operations. Methods： Twenty elderly patients with intertrochanteric fracture （aged from 78 to 96 years, averaged 84 years） were randomly divided into two groups after surgery： Group A and Group B. Group A were given Miacalcic, calcitriol and active calcium. Group B were given calcitriol and active calcium. The symptoms of the two groups were observed. The levels of serum calcium, serum phosphorus, alkaline phosphatase （AKP）, and the ratio of uric hydroxyproline （HYP）/Creatinine （Cr） were measured. Results： After 8 weeks of treatment, the pain of Group A was alleviated but it had no change in Group B. The level of AKP had no significant changes. The ratio of uric HYP/Cr was decreased in Gronp A but had no significant decrease in Group B. Conclusion： Miacalcic can increase the pain threshold in central nervous system and the level of beta-endorphin thereby rapidly alleviates the skeletal pain. It also inhihites the absorption of the bone. Miacalcic is important in the comprehensive treatment for elderly patients with intertrochanteric fracture in strengthening the efficacy of surgery.

关 键 词：高龄 骨质疏松 骨折 术后治疗 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]